Tuesday, May 23, 2017

In
conjunction with America’s Health Rankings, there is a specific report issued annually
for senior health for each state. America’s Health Rankings Senior Report for
2016 is the most recent report available and it usually parallels health
rankings for Louisiana as a whole, with some exceptions.

Once
again, Louisiana did not rank high for its Senior Health Report. In fact our
state had an overall ranking of 50 out of 50 states.

The
ranking is divided into two sections, “Determinants” (or factors that determine
health outcomes) and “Outcomes.” Although we are 43/50 for outcomes compared to
other states, we ranked 50/50 for our determinants.

Determinants
(or health factors as they are sometimes called) help to predict future
outcomes. Being last in determinants
does not bode well for the future.

How
do our results look and what do they mean? Health determinants are divided into
behaviors, community and environmental factors, policy and clinical care. Let’s
focus on those areas that need improvement (areas in which we ranked in the
bottom 10) as shown here:

Smoking: We ranked
46 out of 50

Obesity: 48

Physical Inactivity:
45, and

Infrequent Dental
Visits: 45

Negative
results for community and environmental factors include:

Poverty: 48

Low rates of Volunteerism:
50

Poor Nursing Home
Quality: 50, and

Food Insecurity:
49

We
also ranked poorly for “low-care” seniors in nursing homes (43) and an inadequate
number of specialty doctors to care for seniors (43).

Finally,
Louisiana continues to rank low in several clinical care measures such as high
numbers of hospitalized seniors (44), preventable hospitalizations (47) and
hospital readmissions (48.)

When
combined, all of these 13 low factors (or determinants) contribute to poor
outcomes as previously mentioned. These poor outcomes include high numbers of
hip fractures (42), low numbers of seniors with self-reported very good or excellent health status (48), high premature deaths (44) the number
of dental extractions (43) and frequent mental distress (42).

A
few “supplemental measures” add to the grim picture with high numbers of
seniors with multiple chronic conditions (48) and cognitive problems (44) when
compared with other states.

Are
there any bright spots in this dark picture? In fact, yes, we have a few
reasons to be optimistic as Louisiana has high numbers of seniors who get their
annual flu shot (12), lots of home health workers (8), infrequent falls (3) and
a low number of senior suicides (25).

Although
it was not the object of the report, the close association between low incomes,
low educational level and poor health continues to haunt Louisiana. Our
reputation as a “happy state” belies the fact that our happiness may be rooted
in a poor understanding of our numerous health shortcomings. Everyone knows
senior citizens who are happy, healthy and even wealthy, but there are huge
numbers that are not. Ignorance about our health outcomes should not equate
with bliss.

As a
society, we can work to improve the health status of our most vulnerable
citizens (both the very young and very old), especially by improving their
economic and educational prospects.

Our
investments in youth education and job training will reap dividends for our
elderly both now and in the future. The best treatment is always prevention, so
we need to look upstream for the causes of so many ills that beset our elderly
citizens and act accordingly.